title: Lower fetuin-A predicts angiographic impaired reperfusion and mortality in ST-elevation myocardial infarction.
abstract: OBJECTIVE
  Fetuin-A is an anti-inflammatory negative acute-phase glycoprotein, synthesized by the liver. In this study, we aimed to investigate the effects of admission fetuin-A levels on coronary and myocardial blood flow and short- and long-term prognosis in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention.
  
  
  RESULTS
  One hundred eighty consecutive patients admitted with diagnosis of STEMI and 55 healthy age- and sex-matched volunteer controls were enrolled in the study. Patients with STEMI were divided into 2 groups in respect to thrombolysis in myocardial infarction myocardial perfusion grade after primary PCI: with thrombolysis in myocardial infarction myocardial perfusion grade 0-1-2 and thrombolysis in myocardial infarction myocardial perfusion grade 3. Serum levels of fetuin-A were lower in patients with STEMI than in the healthy group subjects. In-hospital and 1-year deaths were significantly higher in patients from the abnormal perfusion group. In-hospital major adverse cardiac event (MACE) and 1-year follow-up MACE also were significantly higher in patients from the abnormal perfusion group. The receiver-operating characteristic analysis indicated an optimal cut point of less than 200 μg/mL, which detects 1-year mortality with a negative predictive value of 95%. The 1-year mortality rate and 1-year MACE were significantly higher in patients with low fetuin-A level as compared with those with high fetuin-A level.
  
  
  CONCLUSIONS
  Because low-admission fetuin-A levels are associated with impaired coronary flow in STEMI patients undergoing primary percutaneous coronary intervention, admission fetuin-A level detection may be helpful in identifying the patients at a greater risk of poor coronary blood flow and worse short- and long-term prognosis.
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Basar
authors.forename: Nihat
authors.initials: N
authors.lastname: Sen
authors.forename: Selcuk
authors.initials: S
authors.lastname: Kanat
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Ozlu
authors.forename: Firat
authors.initials: F
authors.lastname: Ozcan
authors.forename: Serkan
authors.initials: S
authors.lastname: Cay
authors.forename: Gonul
authors.initials: G
authors.lastname: Erden
authors.forename: Kumral Ergun
authors.initials: KE
authors.lastname: Cagli
authors.forename: Metin
authors.initials: M
authors.lastname: Yildirimkaya
authors.forename: Orhan
authors.initials: O
authors.lastname: Maden
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D016022:Case-Control Studies; D003326:Coronary Circulation; D005260:Female; D006760:Hospitalization; D006801:Humans; D007249:Inflammation; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D010477:Perfusion; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015912:Thrombolytic Therapy; D060749:alpha-2-HS-Glycoprotein / Q000096:biosynthesis*
chemical_list: D060749:alpha-2-HS-Glycoprotein